Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease: an MRI study

Gang Zheng, Jiqiu Wen, Hanzhang Lu, Yaxian Lou, Zhiying Pan, Wei Liu, Hui Liu, Xue Li, Zhe Zhang, Huijuan Chen, Xiang Kong, Song Luo, Xiaolu Jiang, Ya Liu, Zongjun Zhang, Long Jiang Zhang, Guang Ming Lu

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objectives: To noninvasively assess global cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO<inf>2</inf>) in young adults with end-stage renal disease (ESRD). Methods: Thirty-six patients and 38 healthy volunteers were included and took part in MR examinations, blood and neuropsychological tests. CBF and OEF were measured by phase-contrast and T2-relaxation-under-spin-tagging MRI techniques, respectively. CMRO<inf>2</inf> was computed from CBF, OEF and hematocrit according to Fick’s principle. Correlations were performed between MR measurements, blood biochemistry measurements and neuropsychological test scores. Results: Compared with controls, ESRD patients had elevated CBF (72.9 ± 12.5 vs. 63.8 ± 8.5 ml min<sup>−1</sup> 100 g<sup>−1</sup>, P < 0.001), elevated OEF (47.2 ± 10.2 vs. 35.8 ± 5.4 %, P < 0.001), but unaffected CMRO<inf>2</inf> (199.5 ± 36.4 vs. 193.8 ± 28.6 μmol O<inf>2</inf> min<sup>−1</sup> 100 g<sup>−1</sup>, P = 0.879). Hematocrit negatively correlated with CBF (r = −0.640, P < 0.001) and OEF (r = −0.701, P < 0.001), but not with CMRO<inf>2</inf>. Altered neuropsychological test scores of ESRD patients were associated with OEF and CBF, but not with CMRO<inf>2</inf>. There were weak relationships between eGFR and hematocrit (r = 0.308, P = 0.068) or CBF (r = 0.318, P = 0.059). Conclusion: Our findings suggested that anaemic young adults with ESRD may afford higher CBF and OEF to maintain a normal CMRO<inf>2</inf>. Despite this compensatory process, however, cognitive function was still impaired and its severity was correlated with their CBF and OEF abnormality. Key Points: • Anaemic young adults with ESRD may afford higher CBF and OEF.• Anaemic young adults with ESRD maintain a normal CMRO<inf>2</inf>.• Cognitive function was still impaired in young ESRD adults.• The severity of cognitive dysfunction correlated with CBF and OEF changes.

Original languageEnglish (US)
JournalEuropean Radiology
DOIs
StateAccepted/In press - Sep 3 2015

Keywords

  • Cerebral blood flow
  • Cerebral metabolic rate of oxygen
  • End-stage renal disease
  • Oxygen extract fraction
  • Uremic encephalopathy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease: an MRI study'. Together they form a unique fingerprint.

Cite this